Provider Demographics
NPI:1619411576
Name:STOK, KRISTIN (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:STOK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SAINT MARY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3986
Mailing Address - Country:US
Mailing Address - Phone:219-228-6137
Mailing Address - Fax:219-286-3708
Practice Address - Street 1:3800 SAINT MARY RD STE 102
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3986
Practice Address - Country:US
Practice Address - Phone:219-286-3707
Practice Address - Fax:219-286-3708
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28161528A363LF0000X
IN71006764A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily